A Hickman Broviac indwelling catheter is generally flexible and is comprised of a small permanent rubber internal tubing portion that is surgically implanted into the right atrium of the heart; an external tubing extending from the exit site where the internal tubing portion extends from the patient's body; and an enlarged capped portion attached to the end of the external tubing portion.
Catheter tubes are used by the medical profession to provide easy access to a patient's circulatory system. Such a catheter is generally used for drawing blood, administering chemotherapy medications, and/or for giving blood products or other substances to the patient. A cancer patient who requires frequent blood tests or chemotherapy will have such a surgically implanted catheter. Even though a catheter such as the Hickman Broviac catheter requires daily care since it must be irrigated or flushed each day with a solution, it offers advantages to the patient. The alternative would be to endure the frequent administration of needles resulting in several needle punctures on the body. Such an implanted catheter also lessens the fears, anxiety and/or risks of skin infections generally associated with frequent needle use.
In the past, the externally extending catheter tubing portion of the implanted catheter extending from the exit site of the body with its capped free end were taped to the body to prevent displacement and/or dislodgment of the catheter. Each time the capped free end of the catheter was to be used, it was first necessary to remove the tape that secured the externally extending tubing portion to the body. Since the tube has to be flushed out at least once a day to prevent clogging, this meant that the tape had to be removed at least once a day. This frequent removal of the tape from the body generally resulted in sores and/or irritation to the body and thus, discomfort to the patient. Therefore, the tape-retention method for securing the catheter tube to the body was found to be highly undesirable and unsuitable. In addition to the sores and/or skin irritations, the tape did not afford the desired freedom of movement in that the patient constantly feared dislodgment of the catheter from its exit site on the body. Additionally, instead of being aesthetic the tape tended to be unsightly thereby creating mental distress especially to the more sensitive patients e.g. children.
When multiple catheter tubes were utilized, the mental distress in using the tape-retention method became even more pronounced, along with an increase in the difficulty and the pain associated with the tape removing and reapplying process.
Garments for holding and/or storing catheters or similar devices in various positions on or to the patient's body have evolved. These garments have lessened or eliminated many of the disadvantages inherent with the tape-retention method for the catheter tubes. Some of these garments or devices are described in the prior art.
In U.S. Pat. No. 4,578,062, Wilma F. Pavelka discloses a garment generally comprised of three elements including a triangularly shaped pocket for holding, storing, supporting, and receiving an indwelling catheter e.g. a Hickman Broviac device. A first strap-like element is attached to the triangularly shaped-pocket. This first strap-like element wraps the device around the patient's waist. A second strap-like element is connected to the triangularly-shaped pocket and to the first strap-like element to provide vertical support to the pocket and extends around the shoulder of the patient to position the garment against the upper torso of the patient. The inner surface of the pocket contains an opening through which the catheter is inserted for storage therein when the catheter is not in use and while the internal tubing portion is implanted into the body.
In U.S. Pat. No. 4,578,062, Paul E. Schneider discloses a catheter holder in the shape of a cut-off tank top body garment which is fitted securely around the patient's chest by an elastic band around the base of the garment. The holder is structured so as to provide a pouch on the inside of the tank top body garment and against the patient's chest. At the top of the pouch, a lip is formed by folding the fabric around another elastic band which maintains the shape of the pouch, which in turn supports the catheter tube when the tube is not in use but which tube is still implanted into the patient's body.
In U.S. Pat. No. 4,666,431, Kenneth McNeish etal discloses a halter and bra-type garment for retaining a catheter particularly of the Hickman Broviac type having one or two tubes. The catheter-retaining garment comprises a pocket on its outer surface. A slot or opening in the inner surface of the garment allows for receipt of the tubing which generally is stored in the pocket in coiled form while the internal tubing portion is anchored in the patient's body for its connection to the patient's heart.
In U.S. Pat. No. 5,403,285, Sandra L. Roberts discloses an apparatus for securing a catheter tube to a patient's body. An elongated, flexible, elastic member is adapted to extend completely around the chest of a person and over the flexible tube at the location where the tube exits the body. Hook and loop closure members are provided on the flexible member for holding the tube in a coiled position adjacent to the flexible member which tube extends through an opening in the flexible member adjacent to the chest of the patient. A flap is provided on the outer surface of the flexible member for selectively covering up the coiled tube when the tube is not in use. This flap allows easy access to the tube for adding medications, drawing blood, and/or for changing the apparatus so that the apparatus can be washed, cleaned, and re-used. The flexible band has hook and loop fasteners on the ends thereof so that the apparatus can be easily stretched and fastened around the patient's waist.
The prior art discussed herein above discloses a device or a garment having a pouch or pocket means for retaining an indwelling catheter to a patient's body. These devices and/or garments focus more on supporting the external tubing in coiled form when the catheter is not in use, and the pouch or pocket that is provided is generally of a dimension to only accommodate the external tubing when it is in coiled form. In most of these garment and/or devices the external tubing portion needs to be removed from the pocket or pouch in order to be used effectively. For some of these garments, the pocket is located conspicuously on the front of the garment for access to the catheter tube.
There is therefore a need in the medical profession for a garment and/or apparatus which not only allows for easy storage of a catheter when it is not in use, but which also substantially supports the catheter in an inconspicuous manner when in use, e.g. as medication and other substances are being administered into the blood stream of a patient or as blood is being withdrawn for testing.